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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. February 2004) Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 623339910
As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made
a demand for payment of this liability, but it remains unpaid. Therefore,
there is a lien in favor of the United States on all property and rights to
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
Name of Taxpayer GRIMWOOD S MASONRY AND HARDSCAPES
For Optional Use by Recording Office
o23 q.Tr(
Residence 499 SAMPLE BRIDGE RD
ENOLA, PA 17025-1025
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of the lien is refiled by the date given in column (e), this notice shall,
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refflmg of Assessment
(a) (b) (c) (d) (e) (f)
941 09/30/2008 76-0785617 12/15/2008 01/14/2019 3577.80
941 12/31/2008 76-0785617 05/04/2009 06/03/2019 3448.68
941 06/30/2009 76-0785617 09/07/2009 10/07/2019 1982.59
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Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 9009.07
This notice was prepared and signed at DETROIT, MI
the 04th day of February 2010
, on this,
Signature
CS 22-00-0008
T_? 4. a ATitle
for MICHAEL W. COX (800) 829-3903
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2-2004)
Part 1 - Kept By Recording Office CAT. NO 60025x